2014 Vol.26(4)

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Editorial
Expanding the selection criteria of laparoscopic hepatectomy for hepatocellular carcinoma
Po-Da Chen, Chao-Yin Wu, Yao-Ming Wu
2014, 26(4): 360-361. doi: 10.3978/j.issn.1000-9604.2014.07.01
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Adenocarcinoma of esophagogastric junction
Jing-Yu Deng, Han Liang
2014, 26(4): 362-363. doi: 10.3978/j.issn.1000-9604.2014.07.03
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Nonintubated video-assisted thoracic surgery under epidural anesthesia—Encouraging early results encourage randomized trials
Eugenio Pompeo
2014, 26(4): 364-367. doi: 10.3978/j.issn.1000-9604.2014.07.06
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Awake thoracoscopic surgery under epidural anesthesia: is it really safe?
Ryoichi Nakanishi, Manabu Yasuda
2014, 26(4): 368-370. doi: 10.3978/j.issn.1000-9604.2014.08.02
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Original Article
Aberrant DNA methyltransferase 1 expression in clear cell renal cell carcinoma development and progression
Ming Li, Ying Wang, Yongsheng Song, Renge Bu, Bo Yin, Xiang Fei, Qizhen Guo, Bin Wu
2014, 26(4): 371-381. doi: 10.3978/j.issn.1000-9604.2014.08.03
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ObjectiveTo better understand the contribution of dysregulated DNA methyltransferase 1 (DNMT1) expression to the progression and biology of clear cell renal cell carcinoma (ccRCC).MethodsWe examined the differences in the expression of DNMT1 in 89 ccRCC and 22 normal tissue samples by immunohistochemistry. In addition, changes in cell viability, apoptosis, colony formation and invading ability of ccRCC cell lines (786-0 and Caki-1) were assessed after transfection with DNMT1 siRNA.ResultsWe found DNMT1 protein was significantly higher expressed in ccRCC than that of in no-tumor tissues (56.2% and 27.3%, respectively, P=0.018). The expression of DNMT1 was strongly associated with ccRCC tumor size, tumor pathology stage, histological grading, lymph node metastasis, vascular invasion, recurrence and prognosis. Moreover, knockdown of DNMT1 expression significantly inhibited ccRCC cell viability, induced apoptosis, decreased colony formation and invading ability.ConclusionsExpression of DNMT1 protein is increased in ccRCC tissues, and DNMT1 expression is associated with poor prognosis of patients. Experiments in vitro further showed DNMT1 played an essential role in proliferation and invasion of renal cancer cells. Moreover, targeting this enzyme could be a promising strategy for treating ccRCC, as evidenced by inhibited cell viability, increased apoptosis, decreased colony formation and invading ability.
In vitro effect of iASPP on cell growth of oral tongue squamous cell carcinoma
Yu Chen, Wangxiang Yan, Shuqi He, Jiechun Chen, Dan Chen, Zhaoqiang Zhang, Zhiguo Liu, Xueqiang Ding, Anxun Wang
2014, 26(4): 382-390. doi: 10.3978/j.issn.1000-9604.2014.07.05
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iASPP is an inhibitory member of the apoptosis-stimulating proteins of P53 (ASPP) family. iASPP is over expressed in several malignant tumors and potentially affects cancer progression. However, the expression and potential role of iASPP in oral tongue squamous cell carcinoma (OTSCC) have not been addressed. In our study, we detected iASPP expression in OTSCC by immunohistochemistry. iASPP expression is up-regulated in OTSCC tissues. Moreover, in clinical pathology specimens, we found that increased iASPP expression correlates with poor differentiation and lymph node metastasis. Using multicellular tumor spheroids (MTS) and flow cytometry, we demonstrated that iASPP down-regulation arrests OTSCC cells at the G0/G1 phase, induces OTSCC cell apoptosis and inhibits OTSCC cell proliferation. These results indicate that iASPP plays a significant role in the progression of OTSCC and may serve as a biomarker or therapeutic target for OTSCC patients.
Long-term survival outcomes of video-assisted thoracic surgery for patients with non-small cell lung cancer
Wenlong Shao, Xinguo Xiong, Hanzhang Chen, Jun Liu, Weiqiang Yin, Shuben Li, Xin Xu, Xin Zhang, Jianxing He
2014, 26(4): 391-398. doi: 10.3978/j.issn.1000-9604.2014.08.04
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BackgroundVideo-assisted thoracic surgery (VATS) has been shown to be a safe alternative to conventional thoracotomy for patients with non-small cell lung cancer (NSCLC). However, popularization of this relatively novel technique has been slow, partly due to concerns about its long-term outcomes. The present study aimed to evaluate the long-term survival outcomes of patients with NSCLC after VATS, and to determine the significant prognostic factors on overall survival.MethodsConsecutive patients diagnosed with NSCLC referred to one institution for VATS were identified from a central database. Patients were treated by either complete-VATS or assisted-VATS, as described in previous studies. A number of baseline patient characteristics, clinicopathologic data and treatment-related factors were analyzed as potential prognostic factors on overall survival.ResultsBetween January 2000 and December 2007, 1,139 patients with NSCLC who underwent VATS and fulfilled a set of predetermined inclusion criteria were included for analysis. The median age of the entire group was 60 years, with 791 male patients (69%). The median 5-year overall survival for Stage I, II, III and IV disease according to the recently updated TNM classification system were 72.2%, 47.5%, 29.8% and 28.6%, respectively. Female gender, TNM stage, pT status, and type of resection were found to be significant prognostic factors on multivariate analysis.ConclusionsVATS offers a viable alternative to conventional open thoracotomy for selected patients with clinically resectable NSCLC.
Embolization of symptomatic renal angiomyolipoma with a mixture of lipiodol and PVA, a mid-term result
Qiang Huang, Ren-You Zhai
2014, 26(4): 399-403. doi: 10.3978/j.issn.1000-9604.2014.07.04
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ObjectiveTo evaluate the clinical effect of renal artery embolization with a mixture of lipiodol and polyvinyl alcohol (PVA) particles on symptomatic renal angiomyolipoma and to present the mid-term results from our single-center site.MethodsWe performed a retrospective review of the seven patients who underwent embolization with a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma in our center between February 2011 and December 2013. Medical records and follow-up results were reviewed and analyzed.ResultsSeven patients underwent eight episodes of embolization using a mixture of lipiodol and PVA particles to treat symptomatic renal angiomyolipoma. One patient required a subsequent embolization of the right kidney 9 months after the initial embolization of the left kidney. No nephrectomy was required in any of these cases during follow-up. None had recurrence of tumor bleeding or rupture during follow-up. Decreased tumor size was achieved in six patients (85.7%) during the mid-term follow-up.ConclusionsEmbolization with a mixture of lipiodol and PVA particles is an effective and safe treatment for symptomatic renal angiomyolipoma. Based on the durable mid-term results of the present study, a mixture of lipiodol and PVA particles is recommended for embolization.
Decline of serum CA724 as a probable predictive factor for tumor response during chemotherapy of advanced gastric carcinoma
Li Zou, Jun Qian
2014, 26(4): 404-409. doi: 10.3978/j.issn.1000-9604.2014.07.02
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ObjectiveTo evaluate the predictive value of decline in the serum level of carbohydrate antigen 724 (CA724) on tumor response during the chemotherapy in patients with advanced gastric carcinoma (GC).MethodsThe serum CA724 level was determined by electrochemiluminescence immunoassay, while the objective response rate (ORR) was assessed according to response evaluation criteria in solid tumors (RECIST). The association of the changes of serum concentration of CA724 with ORR was analyzed.ResultsThe ORR in CA724 (pretreatment serum level) high and low groups was 32.3% (20/62) and 52.8% (19/36), respectively (P=0.045). The relationship between the reduction of CA724 and the ORR was statistically significant (P=0.044). Receiver operating characteristic (ROC) curve established the best cutoff value of the decrease ratio of CA724 as 20.5%.ConclusionsCA724 decline seems to indicate chemotherapy efficacy in patients with advanced GC, and an average drop of 20.5% in serum CA724 appears to predict the sensitivity to chemotherapy.
TPX2 knockdown suppressed hepatocellular carcinoma cell invasion via inactivating AKT signaling and inhibiting MMP2 and MMP9 expression
Qingquan Liu, Pinghua Yang, Kangsheng Tu, Hongyong Zhang, Xin Zheng, Yingmin Yao, Qingguang Liu
2014, 26(4): 410-417. doi: 10.3978/j.issn.1000-9604.2014.08.01
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ObjectiveTargeting protein for Xenopus kinesin-like protein 2 (TPX2) is a nuclear proliferation-related protein that plays a critical role in the formation of mitotic spindle. High expression of TPX2 has been observed in several types of tumors. However, the role of TPX2 in hepatocellular carcinoma (HCC) remains unclear. Our study aimed to investigate the effect of TPX2 on HCC cell invasion.MethodsThe immortalized normal human liver cell line L02 and six HCC cell lines including SMMC-7721, BEL-7402, Huh-7, HepG2, Hep3B and SKHep1 were subjected to qRT-PCR and western blot for TPX2 mRNA and protein, respectively. Furthermore, TPX2 small interfering RNA (siRNA) was used to knock down TPX2 expression in SMMC-7721 and HepG2 cells. Cell proliferation and invasion were determined by MTT and transwell assays. Otherwise, expression of p-AKT, MMP2 and MMP9 were evaluated by western blot in SMMC-7721 cells.ResultsThe expression of TPX2 in HCC cell lines was markedly higher than that in normal human liver cell line. TPX2 knockdown using a specific TPX2-siRNA reduced the number of invaded cells and inhibited cell proliferation in SMMC-7721 and HepG2 cells. Furthermore, TPX2 knockdown resulted in inactivation of AKT signaling and down-regulation of MMP2 and MMP9 expression in SMMC-7721 cells.ConclusionsOur study identified that TPX2 might contribute to tumor cell invasion through activating AKT signaling and subsequently increasing MMP2 and MMP9 in HCC.
Safety and feasibility of video-assisted thoracoscopic surgery for stage IIIA lung cancer
Wenlong Shao, Jun Liu, Wehua Liang, Hanzhang Chen, Shuben Li, Weiqiang Yin, Xin Zhang, Jianxing He
2014, 26(4): 418-422. doi: 10.3978/j.issn.1000-9604.2014.08.05
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ObjectiveThe current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery (VATS) radical treatment for patients with stage IIIA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery.MethodsA total of 51 patients with radiologically or mediastinoscopically confirmed stage IIIA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher.ResultsA total of 51 patients with non-small cell lung cancer (NSCLC) were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41 (80.4%) had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50 (98%) received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage (>1,000 mL), and the postoperative recovery was satisfactory. Up to 45 patients (88.2%) did not suffer from any perioperative complication, and 6 (11.8%) experienced one or more complications.ConclusionsVATS radical treatment is a safe and feasible treatment for stage IIIA lung cancer.
Biomechanical study of modular hemipelvic endoprosthesis for Type I-IV defect of pelvic tumor
Yang Dong, Hai Hu, Chang-Qing Zhang
2014, 26(4): 431-436. doi: 10.3978/j.issn.1000-9604.2014.08.13
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BackgroundThe modular hemipelvic prosthesis has been used in patient of Type I-IV pelvic tumor with good outcomes, but how to keep the stability between the prosthesis and the residual sacrum is a problem. An additional screw-rod system seems to solve it, but its biomechanical characters are still not well understood, which need experimental evaluation.MethodsSix pelvic specimens were prepared in three conditions (normal intact pelvis, “normal”; the pelvis of left Type I-IV defect and implanted with prosthesis without/with additional screw-rod system, “rod-” and “rod+”). Compressing biomechanical experiments (50-500N) were performed in these three conditions, respectively.ResultsThe loadings during the experiments are in accordance with the linear elastic control mode. Under the increasing loading, the implanted pelvises displaced asymmetrically, unlike normal intact pelvis. The vertical displacement of “rod+” changed significantly, whereas “rod-” did not. For both implanted pelvis, right side displaced less than left side (P values <0.05).ConclusionsThe implanted pelvis showed asymmetric displacement under loading, where healthy side displaced more. The implanted pelvis plus screw-rod system showed less displacement at implanted side but more at contralateral side in comparison with those without screw-rod system.
Fused monochromatic imaging acquired by single source dual energy CT in hepatocellular carcinoma during arterial phase: an initial experience
Shun-Yu Gao, Xiao-Peng Zhang, Yong Cui, Ying-Shi Sun, Lei Tang, Xiao-Ting Li, Xiao-Yan Zhang, Jun Shan
2014, 26(4): 437-443. doi: 10.3978/j.issn.1000-9604.2014.08.15
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ObjectiveTo explore whether single and fused monochromatic images can improve liver tumor detection and delineation by single source dual energy CT (ssDECT) in patients with hepatocellular carcinoma (HCC) during arterial phase.MethodsFifty-seven patients with HCC who underwent ssDECT scanning at Beijing Cancer Hospital were enrolled retrospectively. Twenty-one sets of monochromatic images from 40 to 140 keV were reconstructed at 5 keV intervals in arterial phase. The optimal contrast-noise ratio (CNR) monochromatic images of the liver tumor and the lowest-noise monochromatic images were selected for image fusion. We evaluated the image quality of the optimal-CNR monochromatic images, the lowest-noise monochromatic images and the fused monochromatic images, respectively. The evaluation indicators included the spatial resolution of the anatomical structure, the noise level, the contrast and CNR of the tumor.ResultsIn arterial phase, the anatomical structure of the liver can be displayed most clearly in the 65-keV monochromatic images, with the lowest image noise. The optimal-CNR monochromatic images of HCC tumor were 50-keV monochromatic images in which the internal structural features of the liver tumors were displayed most clearly and meticulously. For tumor detection, the fused monochromatic images and the 50-keV monochromatic images had similar performances, and were more sensitive than 65-keV monochromatic images.ConclusionsWe achieved good arterial phase images by fusing the optimal-CNR monochromatic images of the HCC tumor and the lowest-noise monochromatic images. The fused images displayed liver tumors and anatomical structures more clearly, which is potentially helpful for identifying more and smaller HCC tumors.
Correlation of ADC value with pathologic indexes in colorectal tumor homografts in Balb/c mouse
Xiaojun Li, Hongnan Jiang, Jinliang Niu, Ying Zheng
2014, 26(4): 444-450. doi: 10.3978/j.issn.1000-9604.2014.08.06
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ObjectiveNoninvasive diffusion-weighted magnetic resonance imaging (DWI) is a well-studied MR imaging technique for quantifying water diffusion especially in tumor area. The correlation between apparent diffusion coefficient (ADC) value and apoptosis or proliferation is not clear by now. This study aimed to investigate whether DWI-ADC value could be used as an imaging marker related with pathologic indexes of tumors.MethodsA total of 30 Balb/c mice with HT29 colorectal carcinoma were subjected to DWI and histologic analysis. The percentage of ADC changes and the apoptotic and proliferating indexes were calculated at predefined time points. Kolmogorov-Smirnov distances were considered to determine whether the percentage of ADC changes, and the apoptotic and proliferating indexes were normally distributed. An independent-samples t-test was used to analyze the difference between apoptotic and proliferating indexes in the two groups.ResultsThere was a statistically significant difference in proliferating index between the radiotherapy and control groups (mean proliferating index: 49.27% vs. 83.09%), and there was a statistically significant difference in apoptotic index between the two groups (mean apoptotic index: 37.7% vs. 2.71%). A significant positive correlation was found between the percentage of ADC changes of the viable tissue and apoptotic index. Pearson’s correlation coefficient was 0.655 (P=0.015). A significant negative correlation was found between the percentage of ADC changes of the viable tissue and ki-67 proliferation index. Pearson’s correlation coefficient was 0.734 (P<0.001).ConclusionsOur results suggest that ADC value may be used in measurement of cell apoptotic and proliferating indexes in colorectal carcinoma.
Role of the texture features of images in the diagnosis of solitary pulmonary nodules in different sizes
Qian Zhao, Chang-Zheng Shi, Liang-Ping Luo
2014, 26(4): 451-458. doi: 10.3978/j.issn.1000-9604.2014.08.07
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ObjectiveTo explore the role of the texture features of images in the diagnosis of solitary pulmonary nodules (SPNs) in different sizes.Materials and methodsA total of 379 patients with pathologically confirmed SPNs were enrolled in this study. They were divided into three groups based on the SPN sizes: ≤10, 11-20, and >20 mm. Their texture features were segmented and extracted. The differences in the image features between benign and malignant SPNs were compared. The SPNs in these three groups were determined and analyzed with the texture features of images.ResultsThese 379 SPNs were successfully segmented using the 2D Otsu threshold method and the self-adaptive threshold segmentation method. The texture features of these SPNs were obtained using the method of grey level co-occurrence matrix (GLCM). Of these 379 patients, 120 had benign SPNs and 259 had malignant SPNs. The entropy, contrast, energy, homogeneity, and correlation were 3.5597±0.6470, 0.5384±0.2561, 0.1921±0.1256, 0.8281±0.0604, and 0.8748±0.0740 in the benign SPNs and 3.8007±0.6235, 0.6088±0.2961, 0.1673±0.1070, 0.7980±0.0555, and 0.8550±0.0869 in the malignant SPNs (all P<0.05). The sensitivity, specificity, and accuracy of the texture features of images were 83.3%, 90.0%, and 86.8%, respectively, for SPNs sized ≤10 mm, and were 86.6%, 88.2%, and 87.1%, respectively, for SPNs sized 
11-20 mm and 94.7%, 91.8%, and 93.9%, respectively, for SPNs sized >20 mm.ConclusionsThe entropy and contrast of malignant pulmonary nodules have been demonstrated to be higher in comparison to those of benign pulmonary nodules, while the energy, homogeneity correlation of malignant pulmonary nodules are lower than those of benign pulmonary nodules. The texture features of images can reflect the tissue features and have high sensitivity, specificity, and accuracy in differentiating SPNs. The sensitivity and accuracy increase for larger SPNs.
Clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma
Bo Jia, Yuankai Shi, Mei Dong, Fengyi Feng, Sheng Yang, Hua Lin, Liqiang Zhou, Shengyu Zhou, Shanshan Chen, Jianliang Yang, Peng Liu, Yan Qin, Changgong Zhang, Lin Gui, Lin Wang, Xue Wang, Xiaohui He
2014, 26(4): 459-465. doi: 10.3978/j.issn.1000-9604.2014.08.12
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ObjectiveTo assess the clinical features, survival and prognostic factors of primary testicular diffuse large B-cell lymphoma (DLBCL).MethodsA retrospective study of 37 patients with primary testicular DLBCL was carried out from November 2003 to May 2012. Their clinical features, survival and prognostic factors were analyzed.ResultsDuring a median follow-up period of 39.8 months (5.4-93.0 months), the median progression-free survival (PFS) was 26.2 months (95% CI: 0-65 months) and the 3-year overall survival (OS) rate was 78.4%. Within the whole cohort, the factors significantly associated with a superior PFS were limited stage (stage I/II), lactate dehydrogenase (LDH) ≤245 U/L, international prognostic index (IPI) ≤1, primary tumor diameter <7.5 cm, and patients who had complete response (CR) and received doxorubicin-contained chemotherapy (P<0.05). There was a trend toward superior outcome for patients who received combined therapy (surgery/chemotherapy/radiotherapy) (P=0.055). Patients who had CR, primary tumor diameter <7.5 cm and IPI score ≤1 were significantly associated with longer PFS at multivariate analysis.ConclusionsPrimary testicular DLBCL had poorer survival. CR, primary tumor diameter and IPI were independent prognostic factors. The combined therapy of orchectomy, doxorubicin-contained chemotherapy and contralateral testicular radiotherapy (RT) seemed to improve survival.
Predictive factors associated with gefitinib response in patients with advanced non-small-cell lung cancer (NSCLC)
Lian Chen, Rui Chen, Zhe Zhu, Yichen Zhang, Zhengwei Wen, Yun Li, Xiaoming Li, Yuwen Luo, Liyu Ma, Shuguang Lin, Xin Chen
2014, 26(4): 466-470. doi: 10.3978/j.issn.1000-9604.2014.08.09
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PurposeA number of different clinical characteristics have been reported to singly correlate with therapeutic activity of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in advanced non-small-cell lung cancer (NSCLC). This study aimed to identify predictive factors associated with prognostic benefits of gefitinib.Patients and methodsEGFR gene typing in 33 advanced NSCLC patients received gefitinib (250 mg/day) were analyzed with mutant-enriched PCR assay. Gefitinib response was evaluated with potential predictive factors retrospectively.ResultsThe overall objective response rate (ORR) and median progression-free survival (PFS) in the 33 patients treated by gefitinib were 45.5% and 3.0 (2.0-4.0) months. The ORR and median PFS in EGFR gene mutation patients were significantly higher/longer than those in EGFR gene wild-type patients (P<0.01). Similarly, the ORR and median PFS in non-smoker patients were significantly higher/longer than those in smoker patients (P<0.05, P<0.01, respectively). However, no difference for ORR and median PFS occurred between male and female patients. Logistic multivariate analysis showed that only EGFR mutated gene was significantly associated with the ORR (P<0.01). Both EGFR mutated gene and non-smoker were the major factors that contributed to PFS (P<0.05).ConclusionsEGFR mutated gene and non-smoker status are potential predictors for gefitinib response in NSCLC patients.
Combination of percutaneous radiofrequency ablation with transarterial chemoembolization for hepatocellular carcinoma: observation of clinical effects
Hui-Chun Liu, Er-Bo Shan, Lei Zhou, Hao Jin, Pei-Yuan Cui, Yi Tan, Yi-Min Lu
2014, 26(4): 471-477. doi: 10.3978/j.issn.1000-9604.2014.08.18
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ObjectiveTo observe the clinical effect of radiofrequency ablation (RFA) combined with transcatheter arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC).MethodsA total of 92 cases of advanced primary liver cancer underwent TACE and RFA treatment from June 2005 to 2011 at the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College. A total of 88 cases with complete clinical treatment and follow-up data were divided into two groups: 43 patients treated with TACE (TACE group) and 45 patients that received TACE combined with RFA treatment (TACE + RFA group). After clinical data assessment, tumor size and survival status were not significantly different between the groups as determined by stratified analysis.ResultsBefore and after surgery, spiral CT radiography and color comparison observed ablation conditions. The tumor necrosis rates after treatment (CR + PR) were 67.4% (29/43) and 91.1% (41/45) for the TACE and combined treatment groups, respectively, and the difference was statistically significant (P<0.05). The quality of life was significantly improved for patients undergoing TACE + RFA compared with the control group. Survival duration was not significantly different in patients undergoing TACE + RFA compared with the control group.ConclusionsIn this study, the effect of RFA combined with TACE treatment was better than TACE alone in treating advanced HCC.
LRP5 polymorphism—A potential predictor of the clinical outcome in advanced gastric cancer patients treated with EOF regimen
Xin Liu, Ming-Zhu Huang, Zhi-Yu Chen, Xiao-Yin Zhao, Chen-Chen Wang, Wei Peng, Ji-Liang Yin, Jin Li, Xiao-Dong Zhu
2014, 26(4): 478-485. doi: 10.3978/j.issn.1000-9604.2014.08.22
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PurposeWnt pathways control key biological processes that potentially impact on tumor progression and patient survival. The present study analyzed the polymorphism of lipoprotein-related receptor 5 (LRP5) (gene with key functions in Wnt signaling) and its impact on the response to chemotherapy and survival of patients with advanced gastric cancer (AGC).MethodsA total of 107 consecutive patients with AGC treated with first-line chemotherapy of EOF regimen were enrolled in the present retrospective study. The association between single nucleotide polymorphism (SNP) of rs3736228 in LRP5 and the clinical outcomes of the patients was studied.ResultsThe CC genotype of rs3736228 was significantly correlated with a higher disease control rate when compared to the CT and TT genotypes (89.3% and 61.8%, respectively, P<0.001). A univariate survival analysis also showed that the progression free survival (PFS) and overall survival (OS) for the patients with the TC and TT genotypes of rs3736228 were worse than for the patients with the CC genotype (PFS: 3.3 and 6.7 months, respectively, HR =0.454, P<0.001; OS: 8.1 months and 18.8 months, respectively, HR =3.056, P<0.001). A multivariate Cox model incorporates rs3736228 and clinical features, also identified rs3736228 was significantly associated with the PFS and OS.ConclusionsOur results firstly highlight the importance of LRP5 gene of Wnt pathway in the treatment of AGC and identify polymorphism of rs3736228 as independent predictor of disease control rate, PFS and OS in AGC patients treated with first-line chemotherapy of EOF regimen in the Chinese Han population.
Brief Report
Maintenance treatment of trastuzumab for patients with advanced breast cancer to achieve long term survival: two case reports and literature review
Min Yan, Hui-Min Lv, Meng-Wei Zhang, Shu-De Cui
2014, 26(4): 486-492. doi: 10.3978/j.issn.1000-9604.2014.08.10
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Molecular subtyping of breast cancer may provide additional prognostic information regarding patient outcome. The epidermal growth factor receptor (HER2) overexpressing breast cancers are designated as HER2-postive (HER2+) breast cancer and carry a particularly unfavorable prognosis. We present two cases of HER2-postive metastatic breast cancer (MBC) who are found to be a challenge to treat, especially due to the occurrence of brain metastasis. Trastuzumab-based therapy improves clinical outcomes, even if the patient has undergone multi-line treatment. These case reports also emphasize the importance of retesting HER2 status because it can be discordance in receptor status between primary and recurrent breast cancer.
Review Article
Function of PCA3 in prostate tissue and clinical research progress on developing a PCA3 score
Yue Wang, Xiao-Jun Liu, Xu-Dong Yao
2014, 26(4): 493-500. doi: 10.3978/j.issn.1000-9604.2014.08.08
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Prostate cancer gene 3 (PCA3, also known as DD3) is a new biomarker that could improve the accuracy of prostate cancer diagnosis. It is a great biomarker with fairly high specificity and sensitivity. The incidence of prostate cancer is rising steadily in most countries. The commonly used prostate-specific antigen (PSA) test once gave people hope for early diagnosis of prostate cancer. However, the low specificity of the PSA test has resulted in a large number of unnecessary biopsies and overtreatment. During the past decade, many new prostate cancer biomarkers have been found. Among these, PCA3 is the most promising. Due to its great performance in distinguishing prostate cancer from other prostate conditions, PCA3 could likely be applied for early diagnosis of prostate cancer, patient follow-up, prognosis prediction, and targeted therapy. After years of research, we have obtained some knowledge about the sequence of PCA3 gene. We have also determined the relationship between PCA3 and the proliferation of prostate cancer cells and learned some information about how PCA3 affects tumor-related genes and proteins. A PCA3 score has been created, and it has been used in a variety of studies. Some researchers have even applied PCA3 to targeted therapy and obtained a good effect in vitro. This review describes the current state of research, and explores the future prospects for PCA3.
Case Report
Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases
Wei Wang, Sharvesh Raj Seeruttun, Cheng Fang, Zhiwei Zhou
2014, 26(4): 501-506. doi: 10.3978/j.issn.1000-9604.2014.08.16
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A 64-year-old man was admitted to the Sun Yat-Sen University Cancer Center with chief complaints of recurrent abdominal pain and diarrhea for about 3 years and with a history of surgical repair for intestinal perforation owing to stress ulcer. Positron emission tomography (PET)/computed tomography (CT) demonstrated a primary tumor on the pancreatic tail with multifocal liver metastases. Pathological and immunohistochemistry staining revealed the lesion to be a pancreatic neuroendocrine tumor (pNET). According to the latest World Health Organization (WHO, 2013) classification, the tumor was classified as stage IV functional G1 pNET. After referral to the multidisciplinary treatment board (MDT), the patient was started on periodic dose of omeprazole, somatostatin analogues and Interferon α (IFNα) and had scanning follow-ups. Based upon the imaging results, CT-guided radioactive iodine-125 (125I) seeds implantation therapy, radiofrequency ablation therapy (RFA) or microwave ablation technique were chosen for the treatment of the primary tumor. Transarterial chemoembolization (TACE), RFA and microwave ablation techniques were decided upon for liver metastases. The patient showed beneficial response to the treatment with clinically manageable low-grade side effects and attained partial remission (RECIST criteria) with a good quality of life.